Between World War II and the beginning of modern conflicts in Iraq and Afghanistan, few improvements in combat medicine were made. Practices carried out on the battlefield during conflicts in Europe were indistinguishable from the procedures done in the jungles of Vietnam. In fact, deaths from controllable extremity hemorrhage during the Vietnam War and the beginning of Operation Enduring Freedom were virtually identical, claiming the lives of 7.9% of casualties. Many of the lessons learned in casualty care, including the use of tourniquets, analgesics and plasma, were not implemented into best practices and standards of care for battlefield providers. In 1993, under the authorization of the United States Special Operations Command, a study of combat casualty prehospital practices was conducted. Three years later, the findings of that study led to a revolution in combat medicine through the creation of Tactical Combat Casualty Care, or TCCC. The report concluded that correction of extremity hemorrhage, tension pneumothorax, and airway obstructions was not only feasible in the combat environment, but also successful in mitigating preventable deaths.
Implementation of TCCC principles across all branches of the Department of Defense (DoD) has been highly effective. In 1996 Col. Stanley McCrystal, then 75th Ranger Regimental Commanding Officer, mandated TCCC training for all personnel assigned to the Regiment. As a result, none of the Rangers killed in action died as a result of conditions addressed by TCCC preventable death protocols (Holcomb, 2009). Other commands have seen similar improvements in casualty survival rates, including the 101st Airborne Division, and several Special Operations Units. Recognizing both the impact of TCCC on survival rates, and the need for increased access to higher levels of care, Secretary of Defense Robert Gates mandated the extraction of wounded personnel within one hour of injury, shortening the time between application of TCCC and surgical level care. Building on these advances, there is an opportunity to create enhancements to combat medic training, particularly in the area of diagnosing and treating severe trauma.
Medical mannequins are well designed for practicing interventions for medical training, including for TCCC. Medical mannequin manufacturers continue to add features to provide mannequins with lifelike features.
However, more lifelike features in medical mannequins cannot alone address the problem of better medical training for practicing interventions. For example, medical mannequins cannot show shifts in skin tone with medical conditions, due to the materials used for the skin of the mannequins. Likewise, medical mannequins cannot show changes in cognition, such as eye or mouth changes with changing medical conditions. Mannequin eyes, for example, cannot signal confusion due to a prescribed underlying medical condition.
Accordingly, there is a continuing unaddressed need for systems, methods and apparatus for improved training for medical interventions.
Additionally, there is a continuing unaddressed need for systems, methods and apparatus for improving combat medical training, such as exemplified in TCCC.
Further, there is a continuing unaddressed need for systems, methods, and apparatus for presenting to a medical trainee a medical mannequin that can exhibit subtle visual, audible, and/or tactile cues with respect to changing medical conditions.
Further, there is a continuing unaddressed need for systems, methods, and apparatus for presenting to a medical trainee a medical mannequin combined with peripheral medical equipment useful for a medical trainee in making medical decisions.
Finally, there is a continuing unaddressed need for systems, methods, and apparatus for medical training on mannequins that can be easily transported, administered, monitored, and reviewed.